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Coalition by MSKMRI JEE EUN LEE.pdf
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Concept
- Developed for adult patients, using CT/MRI.
- Addresses morphologies (esp. calcaneal overgrowth) not covered by Rozansky’s pediatric system.
- Focus: coalition orientation, facet coverage, and osseous/cartilaginous nature.
Types
- Type I: Linear – coalition parallel or nearly parallel to subtalar joint plane; may include posterior hooking. Most common (64%).
- Type II: Talar overgrowth – talus extends inferiorly over calcaneal facet (14%).
- Type III: Calcaneal overgrowth – calcaneus extends superiorly over talar facet (19%).
- Type IV: Complete osseous fusion – solid bony bar (3%).
Key associated findings
- Location: ~90% involve middle facet.
- Fracture fragments: seen in ~24%, especially Type I with calcaneal hooking and Type III. More often from calcaneus than talus.
- Clinical relevance: guides surgical planning (incision, approach, fragment removal).
Imaging role
- Coronal CT/MRI: best to define coalition type and detect subtle overgrowth or fracture fragments.
- Surgeons should be alert to calcaneal hooking and overgrowth patterns, which correlate with fragment risk.
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